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Abstract

Background: There have been limited data available regarding response of renal artery stenting for cardiac disturbance syndrome (CDS) in atherosclerotic renal artery stenosis (ARAS) patients. The PREMIERE registry was a multicenter, retrospective study to clarify predictors for the improvement of cardiac symptoms after renal stenting.

Methods and Results: We enrolled 51 ARAS patients with CDS undergoing successful renal artery stenting (age 73.3±1.43, 30 males) from 11 hospitals in Japan between January 2000 and August 2015. The improvement of cardiac symptoms evaluated by NYHA functional class was observed in 86.3% (44 patients). According to a univariate analysis, eGFR and echocardiographic indices such as interventricular septal wall thickness (IVS) and early transmitral flow velocity were significantly (P<0.05) associated with the improvement of cardiac symptoms. Stepwise multivariate analysis using those variables with P<0.15 identified IVS as an independent predictor (Odds ratio 0.29; P=0.039). According to receiver operating characteristic (ROC) curve analysis, IVS cut off of 11.9 mm provided the best predictive value with a sensitivity of 78.4% and a specificity of 79.5% (Figure).

Conclusion: The present multicenter, retrospective study demonstrated that echocardiographic indice of IVS was a potential clinical predicator for the improvement of cardiac symptoms after renal artery stenting.